Eyeworld Daily News

3 ASCRS•ASOA Symposium & Congress, San Diego 2015 EW SHOW DAILY Stereoacuity was better follow- ing SMILE compared to LASIK or PRK, and SMILE had a similar aber- ration pattern in both eyes. EW dures. SMILE induced fewer aber- rations than LASIK and PRK. There was no significant drop of image quality after SMILE vs. LASIK or PRK. a prospective, 3-arm study on IOLs and 6-month data from a prospec- tive, clinical trial on the KAMRA inlay. Binocular mesopic contrast sensitivity was measured with and without glare. Inlay patients showed continuous functional vision of 20/40 or better over 4.0 D, and they showed better functional vision at intermediate dioptric ranges when compared to the 3 IOLs. Dr. Assia said the paper conclud- ed that patients implanted monoc- ularly with a small aperture inlay achieved better mesopic contrast sensitivity with and without glare than patients implanted with either the accommodating or multifo- cal IOLs with correction. Defocus curve results showed that the small aperture inlay provided the broad- est continuous range of functional vision (considered 20/40 or better). Pairing a small amount of myo- pia with the small aperture inlay provides significantly improved near and intermediate performance comparable to or better than the 3 IOLs. The multifocal IOLs had better near vision at 40 cm, but at the cost of significantly reduced contrast and increased scatter. "Overall, the inlay performed best at an intermediate range," he said. Elizabeth Hofmeister, MD, San Diego, presented on some of the best refractive papers. One study she highlighted compared myopic patients' optical quality following SMILE, LASIK, and PRK. The paper was presented at the meeting by Pravin Vaddavalli, MD, Hyderabad, India. It concluded that the accuracy of refractive correction was similar in all 3 procedures. HCVA and LCVA tended to be similar in all 3 proce- 'Hot Off the Press' continued from page 1 When using IOLs with sharp truncated edges of high refractive index materials such as acrylic, she recommended orienting the optic/ haptic junction in the infero-tempo- ral quadrant to decrease the percent- age of available edge where light can strike. For the "New Technology" cat- egory, Dr. Henderson was also voted favorite for presenting a new oint- ment that addresses what she called a common complaint of refractive cataract patients—an increase in periorbital fat after surgery. She said that "certain XAF-type prostaglandins act pharmacological- ly on adipocytes and reduce adipose tissue in animal models." Applied topically, the XAF5 ointment currently being developed by Topokine (Boston), she added, delivers XAF5 across the skin and achieves micromolar concentrations in subcutaneous fat. A phase 2 trial of the ointment has been completed and the pos- itive results were presented at the American Academy of Dermatology in March 2015. Dr. Henderson said the ointment could be an adjunct to refractive surgery. In a "Best Advice" round where she went one-on-one against Ste- phen Slade, MD, Houston, Dr. Hen- derson recommended doing macular OCT on all patients, citing a signifi- cant number of macular pathologies she would have missed if she had not started doing OCT screening of her patients. Dr. Slade recommended rap- id psychological profiling for all patients, in which he said the best way to keep all patients satisfied and complaint-free is to learn more about them. Dr. Donnenfeld decided to fore- go the audience vote and dubbed Dr. Henderson "Rookie of the Year." In the lone category Dr. Henderson did not win, Kerry Solomon, MD, Mt. Pleasant, S.C., won audience approval for his pearl for the management of astig- matism: using multiple measuring devices in every case. "No single measuring device will be correct all of the time," Dr. Solomon said. "Use multiple mea- surements, look for consistency, and use your best judgment." During the X-Rounds session, Dr. Donnenfeld announced that 2 devices were approved during the meeting: the AcuFocus KAMRA corneal inlay (AcuFocus, Irvine, Calif.) and the ReSTOR 2.5 low add multifocal IOL (Alcon, Fort Worth, Texas). The latest generation of IOLs including these low add IOLs that have recently entered the market, he said, are "not the same IOLs" that ophthalmologists may be accus- tomed to. In terms of multifocality, he said, "what we learned was wrong." Previously, lenses sought to keep images further apart, letting the brain cancel out the blurrier image. Instead, he said, these lenses place images close together, reducing halos and glare. However, against these new presbyopia-correcting technolo- gies and femtosecond laser-assist- ed refractive cataract surgery, the audience voted for microinvasive glaucoma surgery (MIGS) devices as the most exciting new technology of the year. EW Editors' note: Dr. Henderson has financial interests with Topokine. X-Rounds continued from page 1 X-Rounds panel discusses topics during the session. Drs. Chang, Brown, and Henderson comment on presentations highlighting some of the best papers from the meeting.

• Cover